胸大肌与背阔肌皮瓣修复口腔颌面-头颈肿瘤术后组织缺损的效果观察  

Effects of pectoralis major and latissimus dorsi flap repair on tissue defects after oral maxillofacial-head and neck tumors surgery

作　　者：李可 蒋子超 LI Ke;JIANG Zichao(Department of Oral and Maxillofacial Surgery,Nanyang Stomatological Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市口腔医院口腔颌面外科,河南南阳473000

出　　处：《中国医疗美容》2025年第2期40-43,共4页China Medical Cosmetology

摘　　要：目的探讨胸大肌与背阔肌皮瓣修复口腔颌面-头颈肿瘤术后组织缺损的效果。方法选取2021年3月至2024年33月在南阳市口腔医院进行口腔颌面-头颈肿瘤术患者95例,根据修复方法不同将患者分为胸大肌组(47例)和背阔肌组(48例)。胸大肌组采用胸大肌皮瓣修复,背阔肌组采用背阔肌皮瓣修复。比较胸大肌组和背阔肌组患者创面愈合时间、创面最长直径、皮瓣成活情况、排痰情况、呼吸困难量表(mMRC)、瘢痕量表(VSS)、并发症发生率。结果胸大肌组创面愈合时间和创面最长直径均长于背阔肌组,差异有统计学意义(P<0.05),胸大肌组和背阔肌组患者皮瓣成活情况比较,差异无统计学意义(P>0.05)。与术后1 d比较,出院前1 d胸大肌组和背阔肌组患者排痰情况评分和mMRC评分均降低,出院前1 d,胸大肌组患者排痰情况评分和mMRC评分高于背阔肌组,差异有统计学意义(P<0.05)。术后6个月,胸大肌组VSS评分均低于背阔肌组(P<0.05)。术后6个月,胸大肌组不良反应发生率低于背阔肌组,差异有统计学意义(P<0.05)。结论胸大肌与背阔肌皮瓣修复口腔颌面-头颈肿瘤术后皮瓣成活率较好,胸大肌皮瓣修复创面愈合较慢,但是术后并发症发生率较低,美观度较好。Objective To explore the effects of pectoralis major and latissimus dorsi flap repair on tissue defects after oral maxillofacial-head and neck tumors surgery.Methods A total of 95 patients undergoing oral maxillofacial-head and neck tumors surgery in the hospital were enrolled between March 2021 and March 2024.According to different repair methods,they were divided into pectoralis major group(47 cases,pectoralis major flflap repair)and latissimus dorsi group(48 cases,latissimus dorsi flflap repair).The wound healing time,maximum wound diameter,flflap survival,expectoration,scores of dyspnea scale(mMRC)and scar scale(VSS),and incidence of complications were compared between the two groups.Results The wound healing time and the longest diameter of the wound in the pectoralis major group were longer than those in the latissimus dorsi group,and the difference was statistically signifificant(P<0.05).There was no statistically signifificant difference in the survival of the flflap between the pectoralis major group and the latissimus dorsi group(P>0.05).Compared with 1 d after surgery,the sputum excretion score and MMRC score of patients in the pectoralis major group and latissimus dorsi group were decreased 1 d before discharge.1 d before discharge,the sputum excretion score and MMRC score of patients in the pectoralis major group were higher than those in the latissimus dorsi group,and the difference was statistically significant(P<0.05).At 6 months after operation,the VSS score of pectoralis major group was lower than that of latissimus dorsi group(P<0.05).Six months after operation,the incidence of adverse reactions in the pectoralis major group was lower than that in the latissimus dorsi group,and the difference was statistically signifificant(P<0.05).Conclusions Both pectoralis major and latissimus dorsi flflap repair have high survival rate of flflaps after oral maxillofacial-head and neck tumors surgery.Pectoralis major flflap repair has slow wound healing,but it has low incidence of postoperative complications

关 键 词：胸大肌与背阔肌皮瓣修复 口腔颌面-头颈肿瘤术 组织缺损 

分 类 号：R739.91[医药卫生—肿瘤]